This invention relates to a device which holds endotracheal tubes securely within the patient's tracheal lumen. Endotracheal tubes are usually used to provide a temporary air passage between the lungs and atmosphere when the mouth, throat, or trachea are obstructed. Secure fixation of the endotracheal tube is important to prevent the accidental displacement of the tube from the tracheal lumen, resulting in possible asphyxiation, and to minimize damage to the mucous membrane of the larynx and trachea caused by rubbing of the tube against the membrane. The tube may be moved unintentionally, such as by a shift in the patient's position, by movement of the ventilating equipment or slippage due to inadequacy of current methods of securing the endotracheal tube.
Heretofore, such tubes were usually secured by taping the tube to the facial skin of the patient around the mouth or nose. A number of problems occur when this method is used. For example, tape does not always securely retain the tube in its proper position, and it is often necessary to use tincture of benzoin in conjunction with the tape to provide a stronger bond. However, benzoin often irritates the patient's skin. Sometimes it is necessary to use paper tape, rather than the standard adhesive tape, on patients with highly sensitive skin or allergies to standard adhesive tape. After taping the tube, accidental displacement of the tube may still result from spontaneous movement of the endotracheal tube of the patient or the ventilator. This unwanted spontaneous movement of the endotracheal tube is promoted by the mucous secretions of the patient and the inability of adhesive tape to hold under these conditions. When the movement of the endotracheal tube occurs, readjustment of the tube is often necessary to insure proper ventilation of both lungs. This will require cleansing of the patient and the endotracheal tube and subsequent retaping. Movement of the tube may be so great as to constitute total dislodgement from the trachea in which case the patient is in immediate danger of respiratory arrest. Such an occurence requires complete re-intubation of the patient with all of its attendent risks, such as damage to the oro-pharynx and trachea and esophageal intubation.
A further problem occurs if the person performing the taping lacks extensive experience. A well-trained person will take 2 to 3 minutes in taping the tube in an emergency situation, whereas someone with less experience needs a much longer period to properly tape the tube in place. Often, the time spent in this task is critical to the well-being of the patient, and a speedy insertion and affixation of the endotracheal tube may mean the difference between life and death.
A further problem occurs when a patient may bite the endotracheal tube. This is sometimes prevented by the use of a plastic oral airway which itself needs to be taped into place. The result of a patient biting the endotracheal tube may be the occurrence of an air leak which may result in the ventilator supplying an inadequate amount of oxygen to the patient.
Accordingly, an object of this invention is to provide a safe and expeditious method and device for initially fixing an endotracheal tube so as to minimize the movement of that tube. Another object is to provide a method and device which can be efficiently used by those who are inexperienced in the art of endotracheal tube fixation. A further object of this invention is to provide a method and device which will allow for expeditious readjustment of the tube when necessary. A further object of this device is to provide an integral bite lock to prevent perforation or obstruction of the endotracheal tube through biting of the patient.
Further objects will be apparent from the description, drawings and claims.